Multivitamin supplementation describes a daily vitamin and mineral supplement that can help fill nutritional gaps in the diet. In older adults, this may be helpful because aging can make it harder for the body to absorb or get enough nutrients from food.
Good nutrition supports general well-being and cardiovascular function, including how well the heart and blood vessels work, supplying oxygen and nutrients throughout the body. However, there is limited evidence that multivitamins directly improve heart health or prevent cardiovascular disease in healthy older adults.
The COSMOS trial was a large, randomized, double-blind, placebo-controlled clinical trial designed to test whether taking either a commercially available daily multivitamin (Centrum Silver), or a daily cocoa flavanol supplement could reduce the risk of cancer, cardiovascular disease, and other age-related conditions in older adults.
Now, a secondary analysis of the COSMOS trial suggests that daily multivitamin-mineral supplementation modestly improved cardiovascular-related functional health in older adults over a 3-year period.
The study, presented at NUTRITION 2026, the annual meeting of the American Society for Nutrition, found that adults aged 60 years and older who took a daily multivitamin reported better functional health than those who received a placebo.
The improvements included measures of symptom burden and physical functioning, suggesting multivitamins may help preserve day-to-day independence as people age.
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However, because the findings have not yet been published in a peer-reviewed journal, they should be considered preliminary.
The study analyzed data from more than 16,000 participants enrolled in the COcoa Supplement Multivitamins Outcomes Study (COSMOS), a large randomized clinical trial investigating the effects of daily multivitamins and cocoa extract supplements in older adults.
Participants were randomly assigned to receive either a daily multivitamin, a cocoa extract supplement, both supplements, or matching placebos.
After 3 years, researchers found that those taking a daily multivitamin had significantly better functional health scores than those taking a placebo, based on the Kansas City Cardiomyopathy Questionnaire, a validated tool that measures symptoms, physical limitations, and quality of life related to cardiovascular health.
Notably, the largest differences were seen in symptom burden and the clinical summary score, which combines measures of symptoms and physical function.
The benefits were primarily driven by reductions in symptom burden, including fatigue, shortness of breath, and swelling, rather than improvements in physical ability alone.
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The researchers state that the study focused on outcomes that matter directly to older adults, noting that maintaining functional health may help older adults continue everyday activities.
“Multivitamin-mineral supplementation may help preserve functional health in older adults with heart failure, particularly by reducing symptom burden such as fatigue, edema, and shortness of breath,” Jennifer Wong, MD, a board-certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, told Medical News Today.
“While these findings are encouraging, additional research is needed to determine whether these benefits translate into improved long-term clinical outcomes,” Wong, who was not involved in the study, further commented.
The observed benefits from the secondary analysis suggest that multivitamins could reflect improvements in several aspects of health, including cognitive function, blood circulation, and physical stamina.
However, the current study was not designed to determine the biological mechanisms responsible for the effects.
The study authors emphasize that multivitamins should complement, rather than replace, established healthy lifestyle habits, such as healthy eating, regular physical activity, and social connection.
A daily multivitamin could offer a helpful, low-risk addition to a healthy lifestyle to support physical well-being as people age, but is not a substitute for a good dietary plan or exercise.
Unlike multivitamins, cocoa extract did not significantly improve functional health scores across the overall study population.
However, researchers observed a significant benefit among those living with congestive heart failure, suggesting this finding warrants further investigation.
“The finding that cocoa extract may help preserve symptom burden in people with heart failure is an encouraging signal,” Wong added. “However, larger, well-designed clinical trials are needed to determine whether cocoa extract provides meaningful and reproducible clinical benefits before it can be recommended as part of routine care.”
Functional health refers to a person’s ability to perform routine daily activities independently. Health experts consider preserving this ability as an important component of healthy aging, as declines in physical function can reduce quality of life and increase the need for support.
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The findings add to a growing body of research examining whether multivitamin supplements may provide benefits beyond correcting nutrient deficiencies.
For example, previous analyses from the COSMOS trial suggest that daily multivitamin use may support aspects of cognitive health in older adults. However, other evidence remains mixed, and some studies have found little or no benefit.
Because the current research has not yet undergone peer review, it is too early to conclude whether daily multivitamin use directly improves functional health in all older adults. Future analyses will help clarify the strength of the findings and whether they apply to broader populations.
“There are several potential mechanisms,” Wong noted. “Certain vitamins and minerals may help regulate blood pressure, improve blood vessel function, reduce inflammation, support healthy cholesterol levels, and prevent nutritional deficiencies such as anemia.”
“Together, these effects may contribute to better cardiovascular health and improved energy levels, which could help preserve physical function. Improved vascular health may also support cognitive function, although this relationship requires further study,” she added.
For anyone considering a new supplement, it is advisable to discuss it with a healthcare professional, particularly those with underlying medical conditions or who take prescription medications, as some vitamins and minerals can interact with certain treatments.
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“The most important steps are to stay physically active, incorporate regular strength and balance training, follow a heart-healthy, balanced diet, get adequate sleep, and work with your healthcare provider to manage chronic medical conditions,” Wong advised.
“These lifestyle measures remain the foundation for maintaining physical function and independence as we age,” she noted.
“At this time, multivitamins should be viewed as a complement — not a substitute — for healthy lifestyle habits,” Wong emphasized.
“A heart-healthy diet, regular physical activity, adequate sleep, and appropriate medical care remain the cornerstones of healthy aging,” she continued.
“For some individuals, particularly those with nutritional deficiencies or heart failure, multivitamin supplementation may provide additional benefit, but it should be considered an adjunct to these proven strategies rather than a replacement.”
– Jennifer Wong, MD
